Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation
Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute
Medical Subject Headings
Aged; Atrial Fibrillation; Biological Markers; C-Reactive Protein; Female; Growth Differentiation Factor 15; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Proportional Hazards Models; Receptors, Cell Surface; Risk Assessment; Risk Factors
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology
BACKGROUND: We investigated whether circulating concentrations of soluble ST2, growth differentiation factor-15 (GDF-15), and high-sensitivity troponin I (hsTnI) are associated with incident atrial fibrillation (AF) and whether these biomarkers improve current risk prediction models including AF risk factors, B-type natriuretic peptide (BNP), and C-reactive protein (CRP).
METHODS: We studied the relation between soluble ST2, GDF-15, and hsTnI and development of AF in Framingham Heart Study participants without prevalent AF. We used Cox proportional hazard regression analysis to examine the relation of incident AF during a 10-year follow-up period with each biomarker. We adjusted for standard AF clinical risk factors, BNP, and CRP.
RESULTS: The mean age of the 3,217 participants was 59 +/- 10 years, and 54% were women. During a 10-year follow-up, 242 participants developed AF. In age- and sex-adjusted models, GDF-15 and hsTnI were associated with risk of incident AF; however, after including the AF risk factors and BNP and CRP, only hsTnI was significantly associated with AF (hazard ratio per 1 SD of loge hsTnI, 1.12, 95% CI 1.00-1.26, P = .045). The c statistic of the base model including AF risk factors, BNP, and CRP was 0.803 (95% CI 0.777-0.830) and did not improve by adding individual or all 3 biomarkers. None of the discrimination and reclassification statistics were significant compared with the base model.
CONCLUSION: In a community-based cohort, circulating hsTnI concentrations were associated with incident AF. None of the novel biomarkers evaluated improved AF risk discrimination or reclassification beyond standard clinical AF risk factors and biomarkers.
Rienstra, Michiel; Yin, Xiaoyan; Larson, Martin G.; Fontes, Joao D.; Magnani, Jared W.; McManus, David D.; McCabe, Elizabeth L.; Coglianese, Erin E.; Amponsah, Michael; Ho, Jennifer E.; Januzzi, James L. Jr.; Wollert, Kai C.; Fradley, Michael G.; Vasan, Ramachandran S.; Ellinor, Patrick T.; Wang, Thomas J.; and Benjamin, Emelia J., "Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation" (2014). University of Massachusetts Medical School Faculty Publications. 336.